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Sock Doc: Foot Pain & Foot Injuries – Natural Treatment & Prevention

Video Transcript

Hey this is Dr. Gangemi and today’s Sock Doc video is going to be about the foot. I’m going to basically describe and talk about some few easy treatment options that you can use for some common foot aliments that I haven’t discussed in other videos. And we’re going to talk about top of foot pain, Morton’s toe, Morton’s neuroma type issues and peroneal problems as well as your big toe. And a little more about pronation and supination.

So let’s get right to it, pronation will kind of pick up a little bit more where I left off on a plantar fasciitis video. If you want to know about plantar fasciitis, check out that video. We’re not going to talk about that here, even though obviously it’s a food heel problem. But your plantar fascia, that sheath on the bottom of your foot is made up by, or supported by I’ll say, the tibialis posterior muscle. And that attaches to your medial arch. This muscle has an important role in natural pronation, shock absorption, natural rolling inward of your foot. And we’re going to relate that today to supination which is the rigidity of your foot as you push off when you walk and run.

And that has to do with the peroneal muscles which I described a little bit in the knee videos and we’re going to talk about more now as they relate to the foot. So you have three peroneal muscles and they start up here, your peroneus longus comes down the outside of your leg and then wraps around the bottom of your foot and attaches to your first metatarsal and your first cuneiform. Pretty much right underneath the arch of your foot.

So if you’re having a problem with anywhere on the outside of your lower leg and especially if you do this with your foot. If you push it, if you plantar flex it, push down and kind of turn out like that. That would be more of peroneus longus or maybe peroneus brevis type of problem.

Very similar motion, the longus kind of scoops a little bit more where the brevis just kind of pushes out. But, the longus again comes down, wraps around the bottom of your foot, goes to that area. So look for trigger points in the bottom of your foot, right around here, right around underneath your arch just to the inside of your big toe, where the metatarsal is, okay?

And then your brevis muscle starts a little bit lower, here. So, you want to start looking in here and that attaches to the bottom of your fifth ray. Your fifth toe, right about here, okay? So, feel around there for any trigger points. The third one there is your peroneus tertius which is a little muscle that has to do with bringing your foot out and kind of dorsiflexing it like this, which is up and out.

It’s not very often found, I don’t see, I don’t have to treat it that often. But it starts way down here. It’s mostly tendon and then attaches to the top of your fifth metatarsal there, okay? So it’s pretty much that motion like that. So if you feel any pain when you bring your foot out like that, think peroneus muscles, they have a lot to do with supination as I said earlier. And the balance between supination and pronation with your tibialis posterior that I talk a lot about in the plantar fasciitis video. Because it has so much to do with your arch and plantar fasciitis problems.

Now, your big toe is the next muscle we’re going to talk about. Your big toe muscles, your flexor hallucis longus is this type of motion. If you have problems curling your big toe or even plantar flexing your foot. That muscle believe it or not, that helps to curl your big toe like that, starts all the way out behind your fibula. Way up here. So, look for trigger points behind here now, not on the side where you were looking for the peroneus muscles. But in back, again all the way up here for the big toe. And then, on the bottom of the big toe, right around here.

And the next one would be your peroneus brevis which is more of this motion. If I’m pushing down, like that. Rather than this. So this is longus and this is more brevis. And this muscle splays out and attaches to your cuneiform muscle, bones. Which are underneath the arch here, like this. So any big toe issues start digging around in there.

I’ll tell you, even though I find these muscles to be weak and I have to help people with their big toe muscles functioning more and more efficiently. A lot of times it’s because of improper pronation and they are not naturally rolling in on their foot. Because of a tibialis posterior dysfunction. Again, real quick, that would be on the inside where the tendon sheath is of the tibialis posterior. But if you feel like you’re having that sort of problem, check out the shin splints video, because that’s where I really talk about your tibialis posterior.

Let’s go right into Morton’s toe and Morton’s neuroma. Morton’s toe is actually when the first metatarsal is shorter than the second. A lot of people think that you have to have a second toe longer than your first to have a Morton’s toe, but that’s not necessarily the case.

They could actually be, very similar in length but it’s about where this one ends, your big toe. If it ends before the one on the second, your second toe, then you would actually be known to have a Morton’s toe. It really doesn’t mean you’re going to have pain like a lot of people think they do. They say, I have Morton’s toe, even if their toe is obviously much longer, could be a good centimeter or so longer than their big toe.

It means that you’re going to be more susceptible to a problem if you have Morton’s toe. Because you’re not going to pronate as efficiently as you would if you didn’t have that. Where your big toe is the biggest and you can naturally roll in and not hit the longer of the bones before you hit the shorter one. So, if you have a Morton’s toe, it just means if your pronation, supination balance is out of harmony with one another, you’re going to be more susceptible to a problem than if you didn’t have a Morton’s toe.

But again, it doesn’t mean you’re going to have a problem. A lot of foot problems and I talk about this on the Sock Doc site, are from too much stress in your life. That can be poor diet, emotional issues; over training is a big deal, improper footwear, any of these problems that relate to, too much stress in your life, will result in foot problems and cause pronation, tibialis posterior and supination problems, peroneus muscle problems and result in other foot issues too. Such as, arch pain, such as a big toe problem and that sort of thing.

And likewise someone can get what’s called a Morton’s neuroma. Which is when one of the plantar nerves, typically the one between your third and your fourth toe becomes inflamed. Painful, tender red hot, type of pain right in the joint. That some people call a fibro, abnormal growth or if it’s around the nerve, then a neuroma. An inflammation of that nerve. And that again is from muscle imbalances of the foot that have been there for a long time. Although many conventional methods like to treat these things locally with corticosteroid shots and orthotics and that sort of stuff.

But they’re really not addressing the problem if they do that. It’s about the balance of your foot and correcting these natural pronation, supination imbalances that you may have resulting in any other problem. Which also includes top of foot pain. A lot of people have pain on the top of their foot. They think it’s because their shoes are too tight, they tie them too tight.

But it’s really because their arch is being pulled up. Its too, the arch is not naturally flexing and extending when they are walking and running. And the bones are starting to become irritated at the top of the foot. And again, often this is from the bottom of the foot. It’s from the plantar fascia, it’s from the tibialis posterior attaching to the arch here and the bones in the bottom of your foot. It’s from tibialis posterior problems way up here on the inside of the tibia.

It’s from pronation problems, sorry, peroneus problems, supination problems on the outside of the leg. So, it’s about the balance there. I think the best way to rehab your foot once you find the trigger points and are hopefully starting to feel better or you address the reason for those trigger points, also on the Sock Doc site, is to go barefoot as much as possible or wear as you know, firm, flat, flexible shoes. Shoes with not much of a drop.

This is a zero drop type shoe, meaning there’s no drop from your heel to your fore foot. Just as if you were barefoot. They’re very flexible, just as your foot should be, no support. And they’re letting your foot feel the ground. And feel where you are; develop proper proprioception. Develop proper, what is known as kinesthetic sense, feeling the ground, so your foot knows how to walk, run, jump and play naturally to help rehab these muscles. Rather than isolate them one at a time through perhaps some therapy and exercises or that sort of thing.

The more you are in over supportive shoes, the more you wear orthotics, again, all this is on the Sock Doc site, the more you’re going to cause dysfunction of these lower leg and foot muscles. And the longer you’ll end up with pain and with discomfort. Maybe not while you’re in them, but as soon as you get out of them. You end up basically being devoted to them forever.

So, that should about cover it. If you have any questions feel free to make a comment, thanks.

In this video I discuss how to identify, treat, and prevent common foot ailments. Learn about various types of foot pain and injuries from “top of foot pain” to peroneal tendonitis as well as Morton’s Toe and Morton’s Neuroma. Normal pronation and supination is also discussed. Learn and enjoy!

Comments

I am feeling tightness on both legs on the lateral side of my lower legs. I had a few blisters on by big toes and sprained ankles months back and feel like I am still compensating and running differently from those injuries even though the blisters and ankle discomfort is gone. I run mostly barefoot and in vibrams and am experiencing pain. I am worried that it may go into compartment syndrome. What may I be doing to cause this tightness? What can I do to fix and change it? I hope this make sense.

Sounds like an imbalance between the peroneus longus (supination) and the tibialis posterior (pronation) – just as I describe in the video. So, follow the instructions on the video – got to give it a few days at least to see if it helps (the video is new so you haven’t done it that long yet).

Any Suggestions on fixing the imbalance besides walking barefoot? I have been doing BF walking/ running for 2 years. I have not had any problems until this recent incident and now I can’t get my self back to the way it was. I love BF but even walking BF makes it tight. I did follow the instruction of both the shin splint and this above video it seemed to relieve some of the tension but I am still pretty tight. The more I think about the tightness ,the more I do feel like it is coming from the above muscles mentioned. My lateral side of my ankles on both legs are tight and I feel tightness all the way into the 4 and 5 metatarsal on both feet. Yuck. Thanks for your help!

Hi,
I just saw your video on plantar faciitis. It was very interesting. I couldn’t find any spots like you described in my calf/leg, so I was wondering if what I have is different. It started out by feeling like my shoe was rubbing at the back of my heel, but there was no irritated spot. Then the bottom of my heels started to hurt, and then my arch in one foot. I’ve been wearing minimalist shoes since before they became a ‘thing,’ and go barefoot at home. All of this started after I had my third baby, I saw a new chiropractor who found one leg/hip was turned outwards and adjusted that, and a few weeks later, this started. She also noticed my arch was ‘falling’ on one side (the same side that the arch now hurts on). I normally have high arches, even while bearing weight. Another thing she said is that I am pronating, and that explains the callous under the bone in front of my big toe. I notice that when I am carrying heavy things (like babies and toddlers), I land more heavily on my heels. Aside from what’s recommended in your video, is there anything else that I could do? Would orthotics help at all, in terms of giving my feet a bit of a rest, when I have to move around a lot for my kids and just can’t sit and rest them? Last summer I ordered those minimalist sandals that you make yourself out of a vibram soles… I liked them, but I did find that my feet got sore faster than usual, when walking on sidewalk all day.
I really appreciate any help you can give, because I can’t decide which route to go, continuing with my usually minimalist shoes, even though my feet are hurting in them, or using some birkenstock sandals to support them if that might help them rest a bit and recover.

I keep thinking of more factors that might be important. Like, my feet have always turned out slightly when I walk, and more so when I’m balancing or carrying a load. Also, after reading a bit, the initial pain behind my heel sounds like bursitis. And all of this started after my hip area was corrected for turning out really far about a month ago by my chiropractor. I think I became more aware of how I walked then, after discussing it with her, and maybe paying too much attention to my gait changed how I walked, along with the adjustments for that outward turned leg.
Thanks,
Shira

Could be hormonal since it all started after your 3rd child. Adrenal gland issues are very common with foot problems. Orthotics will support – not correct. Everybody pronates. If you don’t then you ahve a problem. If you overpronate that is from the weaknesses described in the video – again usually a hormonal problem.

Thanks for the video, I enjoyed watching it. I was hoping to glean some more specific ideas, techniques or tools to correct my foot troubles.

My foot is prone to 2nd and 3rd metatarsal head pain, on the bottom of my foot right behind my 2nd and 3rd toe. Front of ball of foot pain, amplified when standing on my toes.

My big toe is longest and sticks out farther than my 2nd toe. But it does appear that the metatarsal or ball of foot area behind the 2nd toe does extend farther forward than the big toe metatarsal. So perhaps I have Morton’s toe as described in your video, but I am not totally sure. Here is more information.

Adding a 1/8 to 3/16 inch thick foam metatarsal pad to my shoes helps manage it. The pain lessens after the pad and insole compress with use. The insole and metatarsal pad develop a depression in the middle (point of initial highest pressure) that seems to take the pressure off my metatarsal heads. Wearing new shoes that have not compressed and formed a crater depression tend aggravate my foot the most. My foot will be sore for a couple days after a long (1+ hour run).

When I am indoors, I do not wear shoes so I spend a lot of time walking around barefoot on carpet and some hard floors. Walking does not bother my foot, but running does. The pain has limited the amount I can run and the length of my runs.

I’ve had the best success with cushioned neutral (level) type shoes. Shoes that have worked well from me are the Skechers GOrun, the Altra Instinct, Hoka Bondi B. Barefoot running, or running in a thin soled non cushioned shoe like the New Balance Minimus tend to aggravate my problem the most.

Other than taking pressure off my second metatarsal head by cushioning and building up the area around it in my shoes, do you have any specific exercises or manipulations that would help with my foot pain? Or help strengthen and change the way my foot interacts with the ground?

I lead a healthy life with regards to stress, diet and activity. I periodically utilize GuaSha (similar to A-Stym) scrapping massage to keep my leg muscles supple and free of trigger points and adhesions.

In regards to intensity, I agree with and follow your philosophy of emphasizing low stress aerobic running over anaerobic. I’m 55 years old. Current max heart rate is 175. Most running is done at 120 to 145. Racing a 5K will bring heart rate up to 170. Low impact (easy on feet) power walking uphill at 4.5 mph 15% grade on treadmill gets heart rate up to 145-155.

I regularly do functional exercises to maintain core strength and dynamic flexibility.

The info on this site is free – though most would pay a lot to read it. I’ll be the first to say the info here does not “fix” every problem in every body. Some it does, and some get a lot of their issues resolved. But some people need to evaluated and treated. That’s individualized – this site can only go so far.

I hear you talking in the video about going barefoot as much as possible. Currently it hurts to walk barefoot – the longer the worse the pain. The pain also doesn’t go away quickly when not walking (like sitting or laying) but throbs and pulls at my toes, balls of my feet, heel, etc. for quite some time. I’m working on the things you’ve shown in your video along my leg and feet. Should I keep walking barefoot even with the pain or try to work my way up to longer time barefoot? I’ve heard that the old adage ‘no pain no gain’ isn’t all that great but does that apply here? Doesn’t the pain also signal ‘whoa buddy, take a break’ type thing?
chuck

hey there, got your reply, plus two others that weren’t for me so this is just and FYI. thought you should know in case they were wondering about a reply.
thank you for your site
chuck

One had someone named Willaim with this text:
Thanks for your response. It leaves me feeling disappointed. I was looking for some concrete specific insight regarding feet. I’ve thoroughly explored you website. Knees and Hips are good. In regards to intensity, I agree with and follow your philosophy of emphasizing low stress aerobic running over anaerobic. I’m 55 years old. Current max heart rate is 175. Most running is done at 120 to 145. Racing a 5K will bring heart rate up to 170. Low impact (easy on feet) power walking uphill at 4.5 mph 15% grade on treadmill gets heart rate up to 145-155. I regularly do functional exercises to maintain core strength and dynamic flexibility.

the other had no name, just your mug shot with this text:
The info on this site is free – though most would pay a lot to read it. I’ll be the first to say the info here does not “fix” every problem in every body. Some it does, and some get a lot of their issues resolved. But some people need to evaluated and treated. That’s individualized – this site can only go so far.

Good video doc. You are one of the very few foot doctors who say that orthotics and supper supportive shoes develop more problems than they solve. I also agree with you about the kinesthetic sense, that it is important to develop it. The same for the proprioceptive sense. I’m not a foot doctor, but I spend a long time learning about feet and about balance. I developed nestoiter-gravity, which is a foot massager that get the feet massaged via gravity. Plus (not advertised) it is also an excellent balance beam that trains the feet and ankles for left/right lateral stability of the feet brought about by challenging balance conditions.
All this started when I was a child and developed an obsession to walk the tightrope. Only thirty years later I actually satisfied my dream. What happened next was almost magic. I recently published a book where I share what I learned in the process and what I discovered simply by observation while I was researching the two main themes, feet and balance. I thank you so much for making this video and informing people of the benefits and shortcomings of the over-supportive shoes and orthotics marketed as the panacea for all problems. Thank you.

I’m curious what your thoughts are on sport-specific shoes (ie. basketball or tennis shoes)? I would assume a minimalist-type shoe would also be recommended in those sports? It seems like most tennis/basketball shoes are also over-cushioned and a high-cut ankle runner for basketball may not necessarily be needed.

Exactly. For the most part, the less shoe the better. Eventually there will be more options for different sports but right now you have to use “running shoes” for these sports, though it really doesn’t matter too much. You just might want some more rubber on the bottom for sports where there is a lot of stopping/cutting so you don’t wear them out so quickly. In regards to basketball, there’s studies out there showing decreased vertical jumps and increased injury rates with hi-top shoes. Yup, I said you’ll jump LESS high.

Just wanted to first thanks for your website and that I have suffered from severe pains in my feet from flat feet and in my ankles. My podiatrist said that i am suffering from a collapsed arch in my left foot and sudden weight gain and prescribed orthotics but now I am still educating myself through your website.

I’ve been wearing custom orthotics for five years and am trying to follow your advice and transition out of them. I would love to come in for therapy from you, but I live in Korea… So I would like to ask a few questions…

1. When walking barefoot and exercising, I would like to stretch my calf muscles and my Achilles tendon, since they feel pretty tight when I’m doing any exercises, so how can I stretch them out?
2. You talked about trigger points- I found mine, so now what? Should I massage them? I’ve been doing that and now they are not sore… Does that mean I’m better? It’s only been a few days- also, do you have detailed instructions on how to work out trigger points or what I’m supposed to do with them? I saw the plantar faciitius video, but couldnt make a proper conclusion.
3. Now I know I have plantar fasciitis(corresponding trigger points), what’s the therapy method? Massage the trigger points and strengthen the feet muscles?
4. After getting better, I plan to go back to playing basketball… Any suggestions as to what footwear? Should I just wear running shoes? I only play once a week but I love it and can’t seem to give it up…

So sorry for the many questions, it’s just I’m so inspired by your website to strengthen my feet and am currently preaching bare feet to my friends here, but unfortunately we only have Nike frees here…

1. When walking barefoot and exercising, I would like to stretch my calf muscles and my Achilles tendon, since they feel pretty tight when I’m doing any exercises, so how can I stretch them out? YOU ‘STRETCH’ THEM BY WORKING OUT THE TRIGGER POINTS WITH YOUR HANDS/FINGERS (IN YOUR LOWER CALVES) AND WALKING BAREFOOT.
2. You talked about trigger points- I found mine, so now what? Should I massage them? I’ve been doing that and now they are not sore… Does that mean I’m better? It’s only been a few days- also, do you have detailed instructions on how to work out trigger points or what I’m supposed to do with them? I saw the plantar faciitius video, but couldnt make a proper conclusion. THREE IS A TRIGGER POINT POST AND VIDEO. IT’S ALL HERE: http://sock-doc.com/2012/04/trigger-point-therapy/
3. Now I know I have plantar fasciitis(corresponding trigger points), what’s the therapy method? Massage the trigger points and strengthen the feet muscles? YES.
4. After getting better, I plan to go back to playing basketball… Any suggestions as to what footwear? Should I just wear running shoes? I only play once a week but I love it and can’t seem to give it up… YES WEAR ‘LOW-TOP’ FLAT RUNNING SHOES.

What a breath of fresh air!
I am a 54 year old active, health-conscious female, I run races ranging from 5 k to half marathons. I have been on the paleo diet for 2 years following a preventive cardiology symposium where the speaker changed my life and explained inflammation we cause in our bodies.
I hike in the Smoky Mountains, run, use a stairmaster, bike ride.
In the past, I wore a minimalist shoe called Nike presto that is low to the ground very flexible and fits like a glove. It really becomes part of your foot. With disappointment, I stopped wearing them when I developed plantar fascitis. I went to a podiatrist who gave me a corysone shot, gave me info on orthotics, put me in physical therapy using stretch bands, etc.
I spent many dollars on heel cups, arch supports, gel this and that and began trying every running shoe that claimed it had cushion, arch support, medial support, stability, you name it.
My feet began to get worse.
After reading your site, I pulled out my dusty presto’s, cancelled any future PT appointments, and began going barefoot in the house.
I began massaging my legs, tight hip and butt muscles with any hard object in sight. I also made an appointment with a myofasial massage therapist.
It is weird, but since these changes 2 days ago, I feel soreness in my feet, but it’s a different kind, I don’t have that same ” I stepped on a stone” feeling. Granted, it hurts but I am hoping we are on to something here. Oh, and I started takins B complex as well as magnesium every night. (in addition to calcium and fish oil, and osteo biflex) Appreciate any comments, thought? : )

Nice work, sounds like you’re on the right track. Though hard to say what you may need for supplements. I never use B-complex in my office and calcium isn’t as necessary as the dairy industry may lead you to believe.

Ohh , ok, I see… I should have bought just the B1 and B5 alone.
I sure wish a doctor like yourself was here in Ohio. I went for a slow casual 3 mile walk today and can hardly walk tonight. This is so not me. I am much more active than this and hope it turns around soon. In the meantime, I do love your websites, blogs, and health and fitness tips!

>
hi like your site: i’am trying to figure out how to use all of this information

> i was working on my calf muscles with a wooden rod and i worked the achilles tendon too hard and now i’am having shocking burning pain along the back edge of my heel. this also happened to me several years ago while running. at that time i just stopped running and it went away. oh by the way i was wearing orthotics. i have been icing the tendon area any other suggestions would be appreciated.
>
> dean

your right no more orthotics, i’ve tried different orthotics over the years and i can honestly say that they have not done anything for me. at this time i took the liners out of my running shoes and have ordered a pair of minimalist shoes and go barefoot around the house and yard for short periods, my foot
gets hot and tingly i still ice and continue to walk about two miles aday i hope that walking is ok for this injury.

Sure – since those bones are part of the flexor hallucis brevis and the flexor hallucis longus runs in-between them, look at those muscles for imbalances/trigger points as well as supination & pronation imbalances as I discuss in the video.

At about 7:00, you begin to talk about TOFP. Could you explain a little more about what stands at the root of TOFP, and how it relates to (1) the arch being too bent, as you describe, and (2) tibialis posterior tightness? As I have commented previously, I have AT, PF, and TOFP. Would I want to try to strengthen the muscles described in this video in addition to massaging them for trigger points? Would simply walking barefoot for a certain amount of time each day (increasing regularly) suffice to strengthen these muscles?

TOFP is really from tension on top of the foot from an imbalance of the muscles of pronation and supination. So what happens is either the tib posterior is firing too hard and tightening the arch (causing TOFP) in response to a weak peroneus longus (supination) or vice-versa. This is the most common, though there are other scenarios. The big idea is that TOFP is simply a symptom of what is going on underneath the foot, not on top.

The best way to “strengthen” these muscles is to walk barefoot – and run too if you can – so yes, I think that’s plenty. I think the best way to correct them is via the trigger points though as you know from reading my post on Trigger Points is that if the points keep coming back then you’re really not fixing the problem by simply treating them over and over again.http://sock-doc.com/2012/04/trigger-point-therapy/

I am certainly in no condition to run at the moment, but I am working on walking barefoot as per the suggestions laid out in your essays on this website. The skin on the soles of my feet is too weak to walk outdoors on the city’s rough concrete for more than 10-20 minutes at a time, but it is improving steadily, if slowly. Sometimes I feel the plantar fasciitis light up a bit when I walk barefoot, but I suppose that this will subside as my feet adapt.

What may be interesting in my case is: if I wear so-called “minimalist” shoes (the Merrel Barefoots and the Vibram FFs are the ones I have tried), the pain gets MUCH worse, especially in the tops of my feet. It sometimes is so bad, and persists so long, that I can’t concentrate at work. But if I actually go barefoot, I have less pain. Biking is also something that really seems to increase the TOFP.

I am in the group of people who tried to transition to “barefoot running” much too quickly and ended up injuring themselves. One year after developing pain in my ankles (during the past year, I have had surgery on one foot, seen two physical therapists, and done a complete dietary overhaul to eliminate any possible nutritional factors), I am still not better. So, I hope that this whole barefoot walking project provides some benefit.

Thank you for the prompt and thoughtful response. It is very encouraging to come to this website and read about “natural” methods of rehabilitating injuries. There is something deeply disturbing about the attitude that industrial technology (cortisone shots, drugs, surgery, etc) is always necessary for good health.

Hope you figure it out Philip. Sometimes you just need to find a doc who will take apart the compensations and figure out the problem because there is so much confusion going on in your body from years of compensations.

I find you website very interesting especially your assumption on orthotics being unnecessary in most circumstances. Do you think that there is a non-surgical and non-orthotical solution to Hallux Limitus? Or Hallux Limitus is not really an issue? Thank you.

This is a great question. When I was big into orthotics I used them many times for patients with Hallux Limitus. One thing we would do was to cut out a part of the orthotic or insole of the footwear right around the first MCP joint so the big toe joint could “drop” down more and flex more during the gait cycle. Now, I think this is a very silly procedure and doesn’t fix the problem; at best it provides temporary relief. If you address the reason for the Hallux Limitus – or Hallux Rigidus – via the flexor hallucis longus and brevis as I describe in the video, (as well as the tib posterior), you’ll correct the problem with the diagnosis of Hallux Limitus.

I have problems with pain under foot and with the ankle. The pain under the foot is getting less but the ankle pain stays. The ankle pain is in the back of the heel (left and right) and on the front. It hurts when i start running but gets less during the run. I also feel it when i walk upon the stairs. I also have calf cramps (during the night).

The cause of the problem was overtraining. I run on vivobarefoot (shorter runs more then a year) and nike run free or Saucony Kinvara 2/3. I am stil in transition phase.

I currently visit a physio who’s using the dry-needling method. (Two visits so far).
He did make an echo of the ankle and everything is okay. I also was tested for magnesium, fosfor, kalium and natrium and everything was okay
He want’s me to strecth (espacially the long calf muscle) for the problems with the ankle. The (left) ankle is less flexible.

I follow your articles (really great, thanks!) and you strongly recommend not to stretch.
So now i am confused. Should i strectch or not? (that’s another the Shakepeare question!

Well of course I would never advise you to stretch this muscle, especially when it’s injured. I think it’s a foolish thing to do.

I take it you were tested for magnesium and the others I’m going to guess are – phosphorus, potassium, and sodium? (where is your far away land – Narnia?)
Blood tests are VERY inaccurate at figuring out deficiencies. Blood levels are the last to change, long after tissue levels are inadequate. So don’t think you have “normal” electrolytes because your blood work was “normal.”

I’d be looking for the trigger points throughout the entire lower leg – front and back – and hopefully that helps.

Thanks for your time answering my questions. The last dry needling therapy helped quit a bit. I even ran for 21 minutes almost pain free. Some minor reaction afterwards and the next day, but it is definitely less than the days before. Happy

I will take your advice and don’t stretch. Will also will do the foot training you suggested in one of the training video’s (Plantar Fasciitis). I also will read the Clear Davies trigger point manual and start to work on the trigger-points myself.

They didn’t test Phosphoros, potassium and sodium. Far, Far away land in the Netherlands. It isn’t that far, but for a live consult it certainly is

I have some other questions. Hope you can give us some advice?
One is about the stretch ‘thing’. Some people don’t stretch before a run, but afterwards. There are some people who give me advice to stretch afterwards against the nightly calf cramps. If i say i don’t stretch, they just can’t believe it. Guess they just think it’s my own fault!

Another questions is about warming up and cooling down.
So what is a good warming up ? And what’s is a good cooling down? How can a warming up and cooling down help for a better recovery. And how can recover? Any advice on recovery (active and passive).

Thanks again for your time and i think it’s great you educate athletes about the benefits of natural injury treatment and prevention.

Very informative video, and I’m hoping it can help with some of the issues I’ve been having with my left foot, though I’d also like to hear your input on my specific problem.

I’ve been having pain in the ball of my left foot that eventually radiates to the base of my big toe and sometimes into my arch after running for half an hour or so. The pain is worst on trails with roots and rocks, especially when going uphill (and I run primarily on trails, so this is no fun). However, the area doesn’t hurt to the touch, minus a few trigger points that I’ve just found thanks to the video and have started to work on. Walking barefoot isn’t an issue.

My trail shoes are Vivobarefoot. I tried Vivobarefoot Lucy Lites for road shoes (I had been wearing New Balance Minimus roads), and that’s when the foot pain started the second time (the first was last fall when I was wearing NB Minimus trail and they had gotten very worn down. When I got a new pair, the problem went away).

Based of your issues with the Lucy Lites and new NB shoes helping, I’d say you’re not quite ready for a zero-drop shoe. You’re getting the classic pronation problem here; I’ve had it before too. Check out the Healthy People = Barefoot People post if you haven’t yet. http://sock-doc.com/2012/03/healthy-people-barefoot-people/

I finally went to the doctor after I started to get some numbness in my toes (inside of my big toe and inside of the 2nd toe), figured I’d gotten a decent amount of swelling in there (though not much visible on the outside) to start messing with the nerves and it was time to see what was going on. They diagnosed Morton’s neuroma and are referring me to a podiatrist. I am not sure I really want to go, but I guess I can hear what they have to say. I’m also not positive it’s a neuroma, as I know of several other conditions (capsulitis and bursitis) that can cause similar symptoms. I haven’t had an x-ray, ultrasound, or MRI to look at it any further. Hoping the podiatrist will at least try these to get a more exact diagnosis.
In the meantime, I’m supposed to stop training for the Detroit half marathon in late October and can’t really get off my feet otherwise, being a farmer. I go a bit crazy when I don’t run. While I do have some pain when I run, I’m typically on dirt roads and trails, which feel a lot better than pavement. It was the combination of a five mile run on pavement one day, then a nine miler on pavement the next day (was out of town, so no trail or dirt road options) that brought on the numbness. So, any suggestions as to some good ways to go about getting better without orthotics and a complete dismissal of running? I am about due for new shoes, too…suggestions?

You have already tried the techniques I have shown in the video – for several days at least? That’s a very uncommon place for a neuroma – but you’d treat it the same as if it were between the other toes. Deep in the calves are typically where the trigger points are. The shoes you are ready for all depends on how strong and healthy you and your feet are currently – that would determine if you can go to a transitional-type shoe or more of a barefoot style.

Yeah, that’s what I thought with the location of the possible neuroma. I’ll keep at the trigger points and see what I can do with those. I definitely have quite a few good ones and haven’t been good at getting to them regularly. I’m still working on the finer points of “training” (aka taking better care of myself despite a hectic life, or not posting at 12am like I’m doing now…oops).
For the shoes, do you have a particular page on the site that describes the different transition types and the barefoot types? As I said above, I’ve been mostly using New Balance Minimus trail and road and those have been doing pretty well for me, or at least I thought they were before this little issue flared up. I’m due for some new ones of both types and was looking at the NB 1010 for trail and am still up in the air about the road shoes. Thinking of checking out what Altra has to offer, or maybe sticking with NB. Thanks again for your responses! Your help and advice is much appreciated.

I don’t think this is the right message. I would believe a Physician over a Chiropractor any day. You guys believe the common cold is the result of a out of alinement spine. You didn’t really address what people who have Morton’s Feet should do. My podiatrist calls them Morton’s Feet because my 2nd and 3rd metatarsals are longer. The fact that I have worn sandals (almost nothing there) and have gone bare feet and still have major pain kind of tells me that I need something in a supportive shoe to help balance it. My doctor gave me pads to go in my running shoes that fit just under the arch and this has finally taken the weight off of the front toes that have been stressed for so long. It is either that or surgery. He saved me from a lot of pain and if he tells me to get orthotics I will do it. I can’t believe anyone would take a Chiropractor’s advice over a real doctor. I hope you know that you could very well being hurting people.

Thanks for your completely unnecessary comment. I love posting comments from ignorant people like you Stacey who hide behind a computer screen and can’t even put their real name or information. Sounds like you’d believe anyone with the “MD” after their name so why are you wasting your time here? You shouldn’t read anything on this site. You don’t know what I do, and you don’t know what chiropractors do.

I have high, inflexible arches and, according to my orthopedist, don’t pronate at all. I have always spent a lot of time barefoot (I hate arch supports and have tried to avoid them for years), but in the past year I’ve overdone it, and have developed peroneal tendonitis at times and, currently, extensor tendonitis (top-of-foot pain). My question is simple: can I make my arch more flexible? Can I learn to pronate? Or am I stuck forever with high, inflexible arches? If the former, what exercises will accomplish this? I am now comfortable if I wear some cushioning or walk barefoot on irregular surfaces (lawns, trails) so that the heel and ball aren’t the only parts of my foot that touch the ground. But if I’m walking or standing on a flat floor or sidewalk for more than half an hour, being barefoot (or close to it) is really painful. And forget about running!

Sounds to me like you’re the type of person who would benefit from some deep tissue work – look for a rolfer, a massage therapist, or a physical therapist or chiropractor who specializes in soft tissue work.

Also feel free to post (in the forum) a video of your feet while walking; I’d really be interested to see if you truly don’t pronate.

this is crazy, but I have been walking vertically along the garden hose back and forth along the hose in my bare feet, and by golly the feet feel nice afterwards. the plantar pain eases up. is this nuts?!

When I swim my mile at the pool, I noticed it flares up the heel pain. You would think swimming would do the opposite! I mean, there is no pressure on the body, etc. Same after cycling, but cycling I can understand. I have to limp to the locker room. Once I get in the locker room, I walk back and forth several times on this thick rubber floor mat with these big holes throughout the mat that drain the water. The mat is bumpy and uneven but it helps the pain! Whaaaaat?! : )

Sock Doc,
I’ve been subscribed to your RSS feed for a while, but have not been injured, so it was mostly for informative purposes….until now.

I’m living in another country where health care is not so good, so I can’t run to the closest sport doctor. I’ve self identified that I’ve strained my Peroneal Brevis tendon. What do I need to do? It feels okay while I run, but the rest of the day, only when walking, it is sore.

I think I sustained the injury last week on a very rocky goat path. This hasn’t bothered me before, and I was thankful to have remembered that you spoke on the subject! Can you give me some advice?

I am a 57-year-old female runner. I usually run in Altra Lone Peaks (zero drop trail shoes, no arch support, lots of toe room) on sandy & rocky desert trails near where I live in. My longest runs are 10 miles. The base of my 3rd and 4th toes has slowly been getting number and number underneath. The area has very blunted sensation, kind of as if there was a thick callous on my foot where those toes emerge, but there isn’t any callous. Since there is no pain, I still run but I’m very concerned that it could lead to some kind of pain. Is this possibly Morton’s Neuroma and should I be doing something differently to reverse it?

My name is Max Lockwood. I am friends with Mark C out in WVA via his run store. Like Mark, i got into the natural running world due to injury. My big toe on the left foot has some rigidity and spurring due to years of wear and tear. It is not in great pain but I have a bit of an asymmetrical gait due to lack of full mobility of the hallux. I do some massage and stretching of the toe. Due to the spur there is some bone on bone that goes on.

Hi Max, thanks for the note. Hard to say what else you could try on your own other than the video especially since Dr. Mark I’m sure has given you some advice (and his advice is always good). I’d be happy to check you out sometime – I know you work with Colleen’s son, she can tell you more about my approach.

I have been patient with the progress of healing my plantar fascitis. In a moment of impatience, I removed my ‘boot’ from my leg and threw it on the floor beside my bed. In deep thought, I pondered what you have talked about all along with how everything is connected in our bodies. While lying there, I propped my calf on the opposite bent knee and while thinking, I felt pain where I had my calf resting on my knee. Hmm, I thought, what is this, and I began to run my bent knee along the side of my calf over the pain, then down the calf. I felt a hard knot, then another knot, and another. I continued to roll my calf over my bent knee until low and behold the knots became fewer. Granted, this was not pleasant but I continued on and did the same with the opposite leg. I repeated this for almost a half hour, with deep massage with my knee. I then wrote the alphabet with my foot in the air. WOW, I heard pops, and crackles like things were opening up!! I heard pops even in my knees, hips and lower back!!! This prompted me to further move up to the hamstrings and try to rub out very tender spots along the sides of my thighs near the hips. In the morning, I got out of bed with way less pain in my feet/heels. Am I on to something here? THis was quite a breakthrough. It was painful during the massaging, but a good pain. It was weird how I stumbled upon this while lying there just thinking. Haha.

Yeah! I can’t wait to continue. Seems there are trigger points just about all over the place! Is there a limit to how often to perform this? Do you do active release technique? I’ve been reading about it.

Thanks for weighing in on my ankle. I apreciate your getting right back to me. I took your advice and cancelled gig. Strangely getting pain up to my knee when I move a certain way, and the PF gets worse with certain shoes. My whole left side feels off. I am going to get a referral from doc on Monday for ortho or sports doc. Have done acupuncture and tuina/reflexology. Better for a few hours but comes back.

any suggestions for treating tarsal tunnel syndrome and where I should be looking for the cause? Nothing I’m learning on other websites sounds very definite and the surgery route, which I’d prefer to avoid, sounds a bit unconvincing. I don’t see anything in what I’ve read on your site but I may have missed it.

That’s a tib posterior issue typically so look for the trigger points there as I show in the video, as well the points for the flexor hallucis longus (big toe). Check out the Shin Splints video too – though you don’t have SS, the muscle imbalance can result in your TTS.

saw the vid on PF which I think you are referring to on the tib posterior and watched the shin splints one. I’ve got some spots on the outside going under the knee that I’m going to work on. I didn’t see anything on the big toe you referred to. I probably missed it, please tell me where.
Douglas

Hi i have a situation where the bottom top of my foot has been hurting for some months now and it seems like my toes are being affected I can’t ware hi heals anymore. When i walk it hurts could you shed some light on what could be worng.

All I can suggest is you follow the advice I show in this video and if it doesn’t help, see the advice of a qualified doc or therapist. High heels are terrible for you body though – you should never walk in them

Thank your for this site and your service. I’ve had pain on the top-right (outside) of my R foot for about a month with no reduction in pain. It seems to have started after I played golf a bit more than usual (i.e. 18 holes instead of 9 on consecutive weekends). I experienced no trauma/injury; there is no redness, bruising or swelling but it is sore if I press on the affected area. The pain is more severe after I’ve been lying down or sitting for some time and lessens slightly after several steps. Everything I’ve read so far seems to indicate tendonitis. What are your thoughts? Are there treatment options besides rest/staying off of it because I walk a lot on my job and I can’t NOT golf! Thank you very much in advance.

I have been working with a personal trainer and now on th bottom of my left foot right before my toes start…my foot has hard like calluses on it. Now it hurts to walk and I am on my feet all day so this is a big deal. Itry and push the hard skin calluses to break it down what can I do? Could it be from my shoes? My right foot is fine though. I have been wearing Nike free to work out in. Sometimes during workouts I know my foot would turn a certin way to compensate did that that lead to this? Can it go away? Joyce

You can’t break up hard callouses like a trigger point. Your body is developing those due to muscular imbalances in the foot and more pressure (friction) on that area. So you need to figure out why and where the foot imbalances are so those points heal up.

Hi, great video. i am currently suffering from plantar fasciitis and it’s driving me insane. i’ve had it for 3 months and tried everything from acupuncture to ultrasound to electrotherapy. then i started going to the gym with my nike free 5.0 , running on the tredmill and it seems like my is actually improving. i also roll around my foot with a tennis ball. i was wondering is there anything i could do? when i sit down for a long time and stand up it would still hurt a bit.

Hi, I have this feeling under my 2nd, 3rd and 4th toes, left foot (I am righty) when I walk barefoot that there is like tissue stuck underneath them. It started about a week ago and happens all the time but only when I am barefoot. Not painful or tingly or anything else. Just the feeling that something soft (tissue, toilet paper) is stuck underneath those toes.

Sock doc, what about capsulitis of the second toe? What do you reccomend for someone who develops pain in the second metatarsal? Is there specific area that some trigger point therapy would help or is rest my only option to get rid of the pain? In my situation i was perfectly fine on a sunday feeling great and used it as a recovery day then had a 2 hour basketball practice and a 2 mile run conditioning after and i know thats a ridiculous amount of running but how could one day cause it to develop?

I have bunions and my big toes are pushed right over with all the other toes pushed almost to the sidel. I have flat feet and turned knees. When I walk barefoot or in flat shoes without any support under them after awhile the bone under my big toes get quite sore to the point where I need to scrunch them up with each stride and also in the walk my heel will also cause pain with each footfall. If I run in barefoot it is the toe only that gets really sore. Can I correct this problem as I would like to try a transition to a more natural running method. I run now in padded wide ridged shoes, however still suffer things like ITB and knee pain if I push it just a little more. Thanking you for such a great website and resource

Try some Correct Toes – it’s the only “orthotic” if you want to call it that, which I recommend. It should help to start to straighten out and relieve that pressure from the bunions.https://nwfootankle.com/correct-toes

Doc, great website. I have recently started rolling my ankle (right) outward on trail runs. Never had that problem before. I run in a neutral shoe, low drop. I am assuming there is an imbalance or weakness in the peroneus muscles??? I am very conscious about foot strike, stride and gait, so I am baffled. I spend a lot of time on the trails, but I am starting to get gun-shy. Any thoughts on what causes the rolling and how to treat/prevent. It is not so serious that I cannot run and it does not result in swelling (yet). Obviously, I would like to “fix” the problem before it gets worse.

Rolling your ankles easily is almost a guarantee it’s an adrenal gland problem where your ligaments are responding correctly to stress. The tibialis posterior fatigues too and pronation problems occur. So think about things that could be causing you too much stress – diet, lifestyle, work, training – everything I mention on the SD site.

I’ve loved your visits to Trail Runner Nation – and have found your website to be an amazingly helpful resource.

I took up trail running a few years back (at age 39) while recuperating from a shoulder imbalance that kept me from swimming… and boy, was I glad to discover running! Here in the SF Bay Area, the trail running opportunities are the bomb.

I’ve had a recurring Morton’s neuroma issue in my left foot – your video has provided some helpful tips. It seems like the neuroma pain is reduced when my hips are more fluid and flexible – which probably helps me walk more correctly. With metatarsal pads, I’ve been able to run and walk without making it worse. Traumeel pills and cream also seem to reduce the sensation.

I can’t find the answer to my question anywhere on your site so here it goes: my neuroma-issue foot seems really susceptible to “snap crackle pop” – when I flex my toes, roll my foot – pretty much any movement of the foot can trigger the popping. My other foot doesn’t make this kind of noise with anywhere near the same frequency. So I ask: is the “snap crackle pop” phenomenon something that is part of a “package deal” with a neuroma?

Hi John. I wouldn’t say that the popping you get is necessarily part of the neuroma issue, but it could be another symptom of the same problem. Though maybe just a coincidence, it might be due to ligament laxity in the foot so when you flex your toes the joints are more mobile. The sound you’re hearing when you crack a joint is simply nitrogen escaping into the joint space (from the synovial fluid). It’s no big deal unless you have pain when it occurs. But if your joints always feel like they need to be popped/cracked or they do so easily, then you’re dealing with some ligament laxity. That’s an adrenal gland issue, which I just happen to have in the works for the next SD article – up hopefully this week if not early next!

I think the ligament laxity point hits home for me. I used to wear orthotics and I noticed that my big toes weren’t doing any work, even when I’m not wearing orthotics. Where this all gels is that when walking or running, when I make a point to activate motion in my big toe with each stride, the neuroma pain doesn’t happen. And suddenly my foot is popping less.

The adrenal gland connection is something I hadn’t ever thought of. I’m definitely a candidate for problems in that area – recovering from serious PTSD the past few years. I started taking liquorice supplements and will look forward to your other recommendations!

I was stepped on by my 1100lbs horse about 8 months ago. When it happened I went to the Dr, had X-rays and told I just had a bone bruise and put in a boot for 8 weeks. I have always been a runner so that was a tough 8 weeks for me, but I even went an extra month without running to be sure my foot was healed. Well, my foot still when I run or wear certain shoes. I went for a run a couple of days ago, and since then i have been in pain. What can I do to prevent this? I love to run and don’t want to stop. Any advice would be helpful. Thank you.

You need to find doc or therapist who understands those types of injuries to help you out. A good doc will be able to get you back in a very short period of time and if not, at least explain why it may take longer.

2 years ago I started a new job that required steel toed shoes. The one I choose where Doc Martens. After a year of wearing them it seemed like i had socks bunching up across the ball area across my feet behind my toes on the bottoms. It got to the point I finally changed shoes and with the next pair which are Throughgood brand I developed a Taylor’s bunion by my little toe on the right side of my foot but the balled up feeling under my feet slowly went away. I could not find a pair of shoes wide enough to not bother the bunion problem so I purchased steel toe over shoes that go on the New Balance shoes I have. Now after 4 months the balled up/thick feeling in the metatarsal area is back, 3 toes on right 1 toe on left. First what I would ask what is this condition called. 2nd how do I help it. 3rd what could you recommend to stay clear of both problems knowing that I have to wear steel toed shoes. I wear a 101/2 length 3/4e width.

Hi Gary – rather than be concerned about “what something is called” it’s more important to understand how you got it. For example, with the Taylor’s bunion it’s nice to give it a name, but that does absolutely nothing for you in regards to treatment and prevention. With the foot problems you’re having, which sound like fascial problems, I’d consider looking for some deep trigger points in the calves as I show in the Foot Pain Video and Plantar Fasciitis Video.

In regards to the shoes – I’m not sure what is out there for steel toes options that are somewhat minimalist. But as with any footwear, make sure you have plenty of room (length AND width) and they’re as flat as you can get them.

I listened to your video on the achilles tendon about walking around barefoot. My son is 11 years old and plays competitive basketball. He had pain last week in his achilles after practice. He rested over the weekend. He played a game on Monday with no pain. He had practice on Tuesday with pain while playing basektbal but was fine afterward. We did ice it before going to bed.

Last night I massaged his calf area and he had no pain walking or going up and down stairs. I wanted to know if he should go to practice or just rest. There is so much information on the internet and I think he had the soreness because his calfs were too tight? What about friction massage?

Honestly I am afraid to go to the doctor as they will say he can’t play as he just recovered from a shoulder injury playing soccer. What about warm-up exercises before playing basketball?

That’s a myth that the calves are “too tight”. With AT, they’re actually fatiguing from the wrong footwear or too much stress – even in an 11 yr old kid. Kids playing basketball SHOULD NOT be wearing traditional high top footwear that all the cool kids are wearing. He should be in a Chuck Taylor – Converse (flat) shoe. If he’s been in a thick heel shoe then you have to slowly transition him down out of them as I explain in the “Lose Your Shoes” article.

Friction massage – trigger point work = same thing. This is what you want to do (not ice) but if it’s temporary relief then it’s not correcting anything, just buying you time. And he should always be warming up aerobically 10 mins before playing hard.

A mail on behalf of a Spanish friend who doesn’t speak English. He did a half-marathon and now has chronic foot pain. He has acute pain on the top of his foot. He was diagnosed as having Morton’s toe, tendonitis and the beginning of artritus. Unsurprisingly, he’s on 2 week’s rest on crutches, anti-inflammatories, and correcting foot orthotics. I know what you recommend about barefoot strenghtening etc and no orthotics but what would you recommend now to get him back to normal walking , just rest ???

For acute injuries I recommend, and follow (of course) the Sock Doc Injury First Aid. Active rest (per pain tolerance). NSAIDs and orthotics will lead him to a weakened foot and a perfect set-up for another injury down the road, in that foot or elsewhere.

In addition to that, it would be the trigger points I describe in the video. Barefoot therapies would be once the inflammation is down and he’s walking pain-free, or close to it.

I have flat feet (over-pronation I believe) as diagnosed by medical doctors, and tend to suffer from morton’s neuroma. Also, as prescribed by the medical doctors, I have been wearing orthotics for almost 6-7 years.

You mentioned in your video that the root problem of this issues has to do with the imbalances of the feet, and suggest barefoot walking and wearing minimalist shoes as solutions.

So how does one transit over to barefoot and minimalism?
What does one have to take note of when walking barefoot?
Is there any correct way of barefoot walking?

About 3 yrs ago i dropped a heavy can on the top of my right foot. It hurt a lot, and i treated it with ice and elevation. A few days later (when it seemed ok) i spent a day in the city walking around (on concrete) and by evening was in terrible pain. A few days later i went to a podiatrist who said he didn’t think a bone was broken and wanted me to buy orthotics. I did not.
Over the past few years this has bothered me on and off, but now it hurts almost all the time. There is (and has been ever since the injury) an obvious though small swelling on the top of the foot. My question is, is there something i can do to try to correct this? Even if a bone was broken years ago, is there a way to heal by doing therapy on myself?

If this was a recent injury I’d say you could probably work out some of the tissue around the area and there are also acupressure points that help with trauma like you had. But now, three years later, you most likely have compensated with other problems from walking on an “injured” foot for so long. I’d look for a doc or therapist (chiropractor, PT, acupuncturist) who can help you with this.

Every since I was a kid (I am now 23) I cannot jump, like off a short brick wall or from the bottom tree branch without terrible pain in the arch of my foot! It almost feels like the middle of my feet break, even though I know they haven’t. I have high arches, and my mom often told me that was why, but I was wondering – is there a shoe insert, or exercises that can help my feet not feel this pain when I do mild jumps? I am planning on joining the CHP very soon, and fear the inability of jumping, or the possibility of climbing a fence and needing to jump fro the top of it during a pursuit would slow me down tremendously!

It’s not because of your high arches and using arch supports will just further weaken your feet, which is why you have pain there assuming you’ve been checked for any health problem that may be causing or contributing to weak connective tissue. Best way to start strengthening your feet is by walking, standing, and balancing barefoot as much as you can. Once you’re pain free there then you can run a bit and jump to build up the muscles, tendons, and ligaments more.

I had a calf injury some weeks ago which I had podiatrist tell me was because I needed neutral shoes due to my relatively high arches. I was using quite supportive shoes. The new shoes give me a completely different sensation – some overall calf soreness initially, but nothing like the injury I had before. Then the calf soreness went away, as i presumed the calf was taking more of the pronation pressure and was learning to cope. I ran nothing more than 40mins initially in them. Now I am more confident in them, but have TOFP which I think is due to the calf problem I had before (i.e. the tendons on top of the foot were not used to the foot pronation I now have). I am icing it, and taking NSAIDS (orally and gel on foot) and I’ll see how it goes. When I push down on the foot there is no pain at all. And none when I curl the toes. So I figure it’s just a “correction” issue. It’s worse in the morning (when cold) and not good when wearing flip flops. I’ll try going barefoot as much as I can too and will report back on results.

Hello. I am trying to get a correct diagnosis on my foot pain, but X-rays do not show a fracture. My foot hit a jet-ski as I was being flung off at high speed. Just the part of my big toe that sticks out on the side (the would-be bunion area) hit the jet-ski. That was ten months ago, and it still hurts.

I have been on profile for it in the military, and need to figure out what treatment will suffice, and quickly.

There are no signs of inflammation, and the pain shoots through my foot sometimes. Generally, it feels a bit of burn, and sometimes it’s shooting pain. My doctor thinks it may be gout, but the blood test results have not come in yet.

I sprained my left ankle 10 weeks or so ago … as part of rehab and as a means to strengthen my ankles and feet, I started swimming breaststroke, doing kicking drills in the pool and recently I started running barefoot on the beach … Thus far I ran twice doing 7 kms each time.

I am experiencing pain on top of my right foot. I could have developed this from the barefoot beach running or the kicking drills (as this is when I first started feeling the pain). I also suspect I’ve been running on the beach at the wrong time when the sand is too soft, thereby not giving my feet the opportunity to pronote and the arches to collapse naturally) … I will aim to run when the sand is harder and more compacted and continue to stick to breastroke .

LO AND BEHOLD!! After over a year dealing with Plantar problems, I woke up the day after Christmas with no foot pain or stiffness in my foot!! What a Christmas present! Before I found your website, I blew tons of money on over the counter orthotics, custom orthotics, ‘good feet’ orthotics, various running shoes! I pulled every orthotic out of my shoes, started following your suggestions, walked barefoot in the house every chance I found, trigger point massage, bought the Theracane, use it faithfully, stretched like a cat/animal does, not like I am trying to move a tree (haha).
All I can say, is you have to have patience and persevere. I think it was all in my hip/glute that made the foot bad! So, now I focus on my legs, back, hips, hamstrings, quads, glutes. You are so right, ya gotta think outside of the foot, most problems in the foot go beyond the foot. Now, why doesnt the foot dr. even tell his patient that? This is something the podiatrist needs to be educated on. I see elderly patients sitting in the waiting room with heavy shoes on that seem like they take so much energy to lift their foot just to walk!! This is setting them back further! My parents are 80, and they wear running shoes, lightweight, and I tell them never to go to those heavy leather ones! Anyway, THANK YOU THANK YOU THANK YOU DOCTOR!! You are AWESOME!

Hey there,
So basically over the past few days all my toes don’t have much mobility and i can’t walk properly and the ball of my foot its really sore, it feels like they are all broken but I only stubbed one toe, I can’t put any pressure on them and it’s affecting the way that I walk, any ideas on what it might be and how to treat it?
Feedback would be greatly appreciated.

I was sent here through a friend. I went for a run today (and the past few times I’ve tried to run I have felt a bunching of the sock sensation in my shoes. I’ve tried different shoes, super feet, without super feet, and different socks, but to no avail.

Then I did a quick looking into this sensation and discovered that I might have Morton’s Neuroma. What further complicates this, though, is that my feet are not normal – I have a birth defect. I only have one fully grown toe with a toenail – the right pinky toe. All of my other toes’ growth was stunted by what is called Streeter’s Bands or Amniotic Band Syndrome. My big toes have big knuckles in them (thankfully because I have good balance), but my other toes are very small – I call them my nubs.

I’m an active person – I played sports growing up and I run and do CrossFit. I used to use the NB Minimums, but noticed some issues when doing so. I now use the Brooks PureConnect for CrossFit and have the New Balance 860s for running.

Wondering if you have any advice for me in my particular situation? I’d greatly appreciate any input you have.

I am not familiar with your birth defect but I’ll say what I say to others with genetic or congenital variations: you haven’t had the pain in your toes your whole life, so don’t think that your congenital issue is the reason for it now. It might make you more susceptible to a problem, but still should not be the reason for it. So I recommend the advice I give in the video for you.

I am a 54 year old woman who has always seemed to have very unstable ankles. About 4 months ago I went over on my left ankle as I was walking on cobble-stones. I didn’t think anything of it as this is a common occurrence with me. However, afterwards my foot was painful and I went to a podiatrist who diagnosed cuboid syndrome. (Prior to this I had noticed a bit of swelling in that foot with some pain on walking)). It was fixed immediately to my great relief. However, the podiatrist then went on to put me in orthotics, and that’s when the troubles seem to really begin. The pronation problem was considered severe so I was put in very riigid orthotics. Two weeks later my feet were in agony (not just the one that I had injured). I was then put into increasingly less extreme orthotics but to no avail. I just pulled them out of my shoes after learning about your site and got better although stil had some niggling pain and stiffness when walking. I went out and got the vivobarefoot mary jane shoes, which were really comfortable. I probably did not transition slowly enough, I am not sure, but about two weeks into wearing them, I got a swollen foot (this time the other foot from the cuboid problem one with the bad pronation). The pain was on the top of the foot. It has subsided quite a bit now but it is still a bit swollen.
Basically, it seems every shoe I put on now, it ends up causing pain but in a different place. I also have tightness in ligaments in my legs at times. My left foot — the one that is swollen now — is one where I broke an ankle over 4 years ago. It does not seem to have a pronation “problem”.

I am very down as all of a sudden I seem to have tendonitis problems which are chronic and are slowing me down. I have now switched my vivobarefoot for some lower heeled shoes just to give the feet a rest. I think your philosphy of treatment and your knowledge of what is really wrong when we get foot pain, etc. is spot on. I am desperate as to know how to proceed now.

I hope to have a video up soon with some easy therapies to use to help strengthen foot and lower leg tissues too.

Other than that remember that the foot is closely related to any and all stress in your life – so consider where your body (life) may be too taxed and do your best to address those areas – diet, exercise, family, work, etc…

Thanks for your quick reply. I will certainly read the information about how to get out of over supportive shoes/orthotics.

I must admit my life has been under quite a bit of stress lately. I would not have connected this to my feet if I had not read the info on your site. I cetainly will try to slow down and improve my diet, which while healthy, is often eaten in a rush. Thanks again, your comments are much appreciated.

Alright, I have this really gross looking yellow patch of very dry, crusty , and hard as rock skin on the ball of my foot. It smells terrible. Whenever I push down on it it hurts. I cant pop my toes on the ground beacause it hurts way too much. I think it is a callus. But, it looks like it is turning into a greenish color. I’ve had this delicously painful thing on my foot for a while now and I recently went on a trip to Disney World and probably did 20 Miles of Walking in total. Agony. My Dads wife said she thought it was a corn but I looked up what corns looked like and whatever is on my foot has a much more greener look , whatever is on my foot is freakin me out. I named the thing on my foot Wallace the Callus.

I had some issues with PF and switched over to barefoot recently. Prior to that I had orthotics with arch support and with some lateral wedge inserts (yikes, i know). Once switching to barefoot the PF has almost gone away. I started running at a very low distance and noticed two things. 1) Slight achilles tendonitis pain in one foot, and 2) then arch pain in the other. I couldn’t find too many trigger points in your videos on these issues, nor did I find any trigger points related to the Proneus muscle in my foot. However I did find some trigger points in my Proneus muscles. They were extremely tight! I worked them out and the next few days it felt like my foot was pronating way more. I could literally feel my walking change. I also noticed just typical walking soreness under the arches of both feet (which felt like a good sign of strengthening).
A few days after the soreness had completely gone away (It took a week or messaging to work out) I went on a hike up and down a mountain (minimal shoes) and I thought for sure my calves would be sore the next day, seeing as I hadn’t done exercises like this in a while. They were not. In fact whenever I have gone barefoot running or mountainous hiking, (I was running longer distances this summer before I sprained my ankle) I have never had tightness in my calves, which I always thought was strange and perhaps an indicator of improper form, because I don’t think my calves are overly strong. Anyways, the next day my Proneus Muscles were really tight again. I didn’t have any achilles pain though! I also used to have a lot of tightness in my fibula head on both sides and that has completely gone away with the messaging of the Proneus muscles.
I am wondering if this issue is just going to take a while to work out and I just need to keep on working on the Proneus Muscles? Does their tightness mean the Proneus muscles are being used too much or too little? Should I be doing exercises for my calves to try to initiate them more into my walking and running gait?
I should also point out that I eat and live a very healthy lifestyle. I am a organic farmer and have very little stress in my life. These injuries are really all that is causing stress in my life. I assume this is more related to my past history with orthotics and still trying to work out the mess they caused.
Thanks for the help,
Ben

Yeah sometimes these things take time, but you’ve seen some great results already.

A tight muscle, like your peroneus, can be because they are working too hard or because they are actually weak. If it’s because they are working too hard, you’ll find the trigger points on the inside of the shin in the tibialis posterior muscle.

I have been running for a little over 3 years now. At first I developed shin splints. Took some time off tried out new shoes and all was well. Next I developed severe pain in the PF. I managed to find that trigger point, worked it out and purchased a better shoe. Again, all worked out great. Its been about a year and all of a sudden I have developed a pain in the front ball of my foot just under my big toe. I can not for the life of me figure what the cause is. Any suggestions?

Read this if you have not (http://sock-doc.com/2012/03/healthy-people-barefoot-people/) and remember that the feet are a great reflection to your overall health and stress. So you’re bouncing around from one injury to another but really haven’t figured out the reason for the imbalances in the foot muscles.

Hi,
Great website! Any advice with healing Morton’s neuroma? Currently dealing with some pain under the ball of my foot near the base of my 3rd toe. Some friends have suggested an epsom salt foot soak. Or how about the good ole’ plain rest and recover tactic?
Thanks!
Chris

I loved this video. Being in the athletic and medical worlds myself I appreciate how you have explained things.

I have struggled with pain on the top of my foot for most of my running career. I though it was from scrunching my toes when I run but even after retraining myself to not do that I still have problems. It seems like the top of the foot pain you described in the video. Is there any specific shoes you would recommend? Is there a different running form I can train in to reduce the pain? It has made me cut my runs dramatically and I want to do a 1/2 marathon in the spring.

Thanks for this web site.
I suspect I have Metatarsalgia or Morton’s Neuroma. At least feels like pebble under front middle ball of foot.
So, does the SockDoc recommend a particular type/brand of sock to help?

Hi. I was hoping you could help me because i fell of the side of the garden’s edge, and i bent my toes, and now they hurt real bad. When i press on it, rub the gel on it or even walk on it hurts.
I have tried using a gel which i used for my tendon when it hurt, i have tried putting an icepack and walking on my heel instead.
Well, please help me. I am twelve years old and i do athletics. I am meant to compete soon, at states so please help.

The muscles which make up your toes start in your lower leg, so have your parents feel around your calf area and rub out any sore spots for you. If you/they press on a spot in your calf that helps relieve the toe pain, you’ll know immediately as the toe(s) will feel better when the pressure is held.

Hi. I’ve been running in 4mm drop shoes for about 6 months and wear flat vivobarefoot Neo’s for social. My problem is that when I reach 4.5miles I keep getting an injury in my feet/ankle.

The first time was in my right foot, pain around the back of my ankle bone. I recovered from that (about 4 weeks) and started running very low mileage again. Last week (over a period of 5 weeks) I reached 4.5 miles again and have just got the same injury, but this time in my left leg. I also currently have a slight pain at the top of my foot where the leg meets the ankle when I raise my heel.

I did have a tender spot in the tibi area, as you show in your vid. I rubbed that over a few days and that is barely a problem now.

I’m frustrated at this 4 mile barrier. I thought my feet where strong, as I wear barefoot shoes for everyday use and I do various foot strengthening exercises.

I’d suggest getting out of your 4mm drop & go to a zero now. Clearly the 4 ain’t working. Or you need a different 4mm shoe – you don’t state which type you’re wearing now. Many 4mm like Saucony Kinvara are far from minimalist.

I rotate between Kinvara 3 and New Balance MT110. I’m just going to rest untill my foot is better and will try 1 mile sjhort runs in my Vivobarefoots, then if everything is ok buy another pair of zero drop shoes.

I know you cannot directly help with my foot problem, but it’s a funny thing. Once one part of the foot seems ok, the pain manifests itself in another area. At the moment it’s the front, both sides of the big tendon that comes down the front of the leg. But it’s been moving all over my foot and lower leg. Weird!

Hi! I run about 30-40 miles a week on the road, trails and track. About a week ago following a half marathon and a 35 mile week, I woke up with pain just at the base of the inside ball of the foot just below the arch. It hurts to flex my toes, press on this spot, walk etc. I have taken 7 days off running with no improvement. Today I had a massage and my hamstring and calf on that side are really tight. No arch pain either – just local to that one area. Any ideas? It doesn’t feel like a sore muscle – deeper and a sharper pain.

Wonderfully done, informative and Pleasantly done video. You have inspired me to make my own videos for my website. If I come half-way close to mimicking your relaxing, informative and confidence building presentation I will be satisfied.
I now know what trigger points and symptoms to check on my son’s sore ankles.

One example says it all, “Morton’s Neuroma is an imbalance of muscles in the foot”. Morton’s neuroma is a nerve inflammation leading to fibrosis, causing thickening and pain of typically the medial and lateral plantar nerves at their convergence between the 3rd and 4th toes.

You do a decent job looking the part “SocDoc”, white coat and decent anatomy lesson but your suggestion that it is caused by “muscle imbalances” and describing no valid treatments should alert the viewing public that your “holistic” meanderings on the subject are incorrect and uneducated.

Caveat Emptor: taking information off of the internet from this chiropractor could be the worst decision you ever make about your health care.

I have been dealing with sever foot pain in the arch of my foot up to my big toe for 1 year now (this weekend marks a year). Let me take you back, I have actually been having foot pain for about 5 years but sever over the last year. I started running in university (10 years ago) and was having some ankle pain. I saw a podiatrist who made me a pair of orthotics. I put these into a pair of running shoes that already had pronation support (as recommended by the running store) and continues to wear the same model of shoe for 6 years. I only used my orthotics in my running shoes. I had on and off foot pain during this time and just thought it was “normal for me.”

This time last year I put my orthotics into a new pair of shoes and went for an outdoor run, well half way through the run I had to stop as my foot was in so much pain. When I composed myself I continued to run home (15 more minutes). The next morning my feet felt like they were burning in pain. Over the next 6 months I tried a number of new running shoes, had to stay off work for a total of 5 weeks as I could not walk, I tried shock wave therapy, NSAIDS, Active release therapy, acupuncture, and the list goes on. I finally got an MRI that showed distal posterior tib tendinopathy with tenosynovitis and edema. My sports med doctor continues to diagnose me with FHL tendinitis so I have been doing physio for about 6 months now with some improvement. My physio treated the post tib issues and has been treating the FHL for the last 4 months. I continue to have a cycle of feeling well followed by flare ups every 2 weeks. At this time I am having pain all over my foot (base of all toes, arch, and adjacent to the arch on the other side of the foot). My physio is doing cross friction massage, laser therapy and electrode therapy as well as stretching and other strengthening exercises that I do daily. I have always felt better barefoot and after trying countless neutral running shoes (I actually have a neutral gait, go figure that I was told I needed orthotics for a slight pronation on one of my feet) I have started to wear barefoot shoes (about 6 weeks now). Why do you think I continue to flare up and is there anything else you could recommend for my treatment plan?

Hello
Very informative website and video- thank you for your commitment for keeping it up and sharing. Even though my story is a long one, I will summarize as best as possible and end with two specific questions for you.
I live on a Caribbean island that has decent overall healthcare, but does not have specialists such as podiatrists, sports medicine docs, etc. Even though I have gone to the US a couple of times to see podiatrists, info. on the internet such as this is very helpful to someone like me.
A little over a year ago, I woke up one morning with a pain on the outside of my foot after a long run, that is still with me today ( I think I started training for a marathon earlier then I should have). Even though it has certainly improved since then, it is still there despite: many weeks of rest, aircast for 6 weeks, orthotics for 8 weeks, crutches for 3 weeks, 2 cortisone shots, traditional therapy, etc.
2 MRI’s at different stages found low grade edema at the base of the 5th metatarsal, which was labeled as low grade stress reaction.
I am obviously very frustrated at this point- doctors here think its no big deal and will heal with time, and have told me its okay to do other things besides running, but I have found that even bike riding and long walks aggravate it.
I just started accupuncture and have high hopes there- what I like is that I can feel the blood flows and twitches, which has meant in the past that it is the midst of improving.
I have also noticed that the right shoes definitely make a difference. Even though it took me a while to figure this out, anything with a heel aggravates it. Unfortunately any running shoe aggravates it even just walking- including NB minimus, Newton Distance, and ones with decent size heel drops like Brooks Ghost. I own all of those and then some.
My questions are – any other advice? I would come see you right away if I wasn’t so far, but I think I will be in that area this Summer- hopefully its still not bothering me then. And what do you think of the German brand orthopedic shoes?- I have had a lot of trouble finding a shoe appropriate for my job, and I bought these $400 semi orthopedic shoes, and those have been the best so far.
Thank you so much- Andrew

Hey Sock Doc – Thanks for the site. I have been experiencing pain on the top of my foot which is preventing me from running. The pain is located on the top of the first (metatarsal and maybe the cuneiform. FYI: According to your video’s specifications I have Morton’s toe. Also my foot cramps pretty much on demand with the most pronounced cramp occurring underneath the first metatarsal and all along the inside of the foot to just below the ankle, causing the big toe to be locked down.

I started wearing vivobarefoot casual shoes a month ago. Could this be related to the transition?

The Sock doc is right. I’ve had exactly the problems you listed and more, a lot more… I’ve been unable to run twice over a six month period. Both times out for 5-6 weeks.

You don’t have to be over doing it by much. I was following a transition plan for beginners and even that was too much.

Take it really easy, don’t wear the vivo’s every day. Once your foot has rested, I found that the sock docs single leg balances (along with others) help to strengthen the ankles over time. Also take 1 or two rest days between running sessions. You’ve probably heard it before but slow progression can be frustrating, but it’s better than injuries.

Once you feel stronger in the ankles wear the vivo’s more often. I also walk around the house barefoot.

Key words (as I’m now following myself) are take it easy, Easy, EASY!!!

Hello Doctor..I’ve seen your video and it’s very informative, thanks. But I have a problem now with my both feet. It’s more than a week now I couldn’t walk normal, it’s still painful and I haven’t go see doctor yet coz I thought it will be okay my feet just need to rest. but now I’m so worried about my feet doc. It happened last march 29, 2013 when go for a walk with my sister, she jogged and I just walked for exercise coz I’ve been sick for 2 weeks from fever and allergy and I decided to take a walk then the next morning my feet was painful, and I thought it’s because of over-walked so I rest my feet in a day and the next day I went for walk again with my mom and my both feet was very painful in the morning I couldn’t get up from bed and move my feet, I really don’t know what to do I’m suffering in pain. I called a therapist and she massaged my both feet. when I woke the next morning my feet was swollen! it got worst than I expected, I couldn’t really get up and walk. last sunday I tried another treatment my friend told me, I mixed the ginger juice on the flour, spread it in clean white cloth and wrapped it on my feet, in two days I keep doing that and it’s effective in a way my soreness of my feet gone. yesterday I’m a bit better I can walk slowly. I tried last night to wrapped again with ginger on my both feet but I’m so irritated when I woke up this morning my both feet is more painful and I can’t walk again… Doctor please help me what I need to do with my feet? I’m so worried now.

hi Doctor,
what is the best treatment for kids ages 3-16 who have down syndrome or global developmental delay who have flat feet, flexible and rigid, some of them have genu valgus…can this deformity even be corrected non-sugically? thank u so much…

Hi Doc, great video on Achilles Tendinitis. It is now clear that I am suffering from it. While trying the therapy you have recommended, would it make sense to continue running, and if so, what intensity of running and type of footwear would you recommend? And if running is not recommended for a while, will walking be a good alternative or is rest advised while I undergo the therapy?

My sister has a morton’s nueroma and had surgery to try and repair it but didn’t work. She now where special shoes to releive the pain. I have tried to tell her that going barefoot more will heal her foot. Is this true?

Hi Doc. Parten my english, i’m from Denmark and I don write english every day. My problem is that I have pain in my feet every day. When I stand up in the morning and even when i have been sitten down for a whiel, then there is pain in my feet when i start walking. When I have walked for a few meters the pain goes away. My doctor says ther is a very good puls in my feet, so he cant understand why I have this pain. I have been runnig in fivefingers for about 2 years now, and i can’t imagin to go back in “nomal” schoos anymore. There is nothing wrong when I run, but when I have been resting and have to start walking, I have pain in both of my feet, until I get going. Can you tell me what I have to do to get this pain away. Thank you for a very god and informativ homepage.

I am a 66 yr. old fairly active woman. I workout with weights/cardio 3 times week and cardio/walking another 3 times a week. I have fairly high arches (nothing like my fathers extremely high arches), and lately bedding will cause my feet to cramp severely or just getting cold will cause cramping.

Getting up in the middle of the night, sliding into the small area of my toilet I move in on tip toe for some reason and this last time it caused horrible top of foot paid that shot to my two webbed toes, (2,3rd toes) then shot up to Achilles tendons and ankle. The top of foot stopped hurting the next day but I have been off my feet most of the week trying to heal my ankle and Achilles. Why would tip toes cause so much pain and involve my webbed toes. My toes are individual, not grown together by bone. They cramp up on top often. Even at my age I have wanted to have them separated. Could they cause this problem?

You were kind enough to respond to a question of mine a few months ago, and I have a follow up.
My previous question centered around a prognosis of “stress reaction”. I have since seen a sports podiatrist who confirms my suspicion that its actually peroneal tendonitis where the tendon meets the base of the 5th metatarsal. The md was helpful in his prognosis, but did not offer much assistance on how to treat besides it will eventually get better.
I have been wearing the dress version of Evo Barefoot shoe for work, which has been great. Out of many different shoes I have bought for work since i’ve had the condition, these have been the best. I also bought one of the running shoes, and tried long walks, with very brief ( 45 seconds) of very light jogging. That still bothers it. If for nothing else, wanted to report back that after 3 different docs, many treatments including cortisone, walking boots, time on crutches, NSAID’s, none of that worked. Its a very stubborn injury, and its interesting that wearing any shoes with heels definitely aggravates it.

A few months ago I went barefoot running, a very short distance, and aggravated my big toe joint. I believe I have turf toe. Any suggestions for how to deal with it? It gets really bad when I over extend or stretch the joint. It hurts the least when i am walking barefoot, which i do often on the farm i work on, and the pain will be all but gone, but when i push it a little bit, it comes back. I have been doing some isolating exercises fo the big toe muscles and found some trigger points on the peroneus muscles, and i think i just found some soreness on the soleus muscles. any other thoughts?

I have been having this pain on the top of my foot above or more like midway from the big toe and ankle on the top. The pain with nonbearing is is throbbing and achy and when I do put weight (when i hop or runn)on it it hurts right below my big toe. I have seen a physician who ruled out stress fx, I dont know what it is and how to treat it.

Im sure you may have already answered this question. And per your video I have some ideas, but I figured Id ask anyway. I have been doing alot of long distance running (half marathon length) and recently I have gotten pain in the joint of my big toe, like it really needed to pop. Now if im walking around with out shoes I can easily pop it over and over by rolling my foot to the outside (a new development). Its definitely getting uncomfortable, and im afraid if I keep running and dont try to correct it, I wont be running much longer.